|
11-desoxycortisol - sendout
|
$45.60 |
$45.60 |
$45.60 |
$84.56
|
|
17-hydroxypregnenolone
|
$100.80 |
$100.80 |
$100.80 |
$85.15
|
|
17-ketosteroids
|
$43.20 |
$43.20 |
$43.20 |
$46.20
|
|
2nd order venous cath
|
$719.40 |
$719.40 |
$719.40 |
$1,635.60
|
|
3-d radiotherapy plan
|
$11,319.60 |
$11,319.60 |
$11,319.60 |
$4,886.50
|
|
3d recon without postprocess indpndt
|
$500.40 |
$500.40 |
$500.40 |
$480.00
|
|
5' nucleotidase - sendout
|
$23.40 |
$23.40 |
$23.40 |
$46.53
|
|
88334 ap bill cytologic exam each additional site
|
$61.80 |
$61.80 |
$61.80 |
$97.65
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$114.60 |
$114.60 |
$114.60 |
$53.68
|
|
Abd aorta w/runoff s&i
|
$5,328.60 |
$5,328.60 |
$5,328.60 |
$3,569.56
|
|
Abd/low ext cath 1st
|
$1,309.20 |
$1,309.20 |
$1,309.20 |
$2,121.00
|
|
Abd/low ext cath 2nd
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$2,158.00
|
|
Abd/low ext cath 3rd
|
$1,864.20 |
$1,864.20 |
$1,864.20 |
$2,639.65
|
|
Abd/low ext cath addl
|
$175.20 |
$175.20 |
$175.20 |
$965.25
|
|
Abdominal CT scan (with and without contrast)
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,976.94
|
|
Abdominal CT scan (with contrast)
|
$1,208.40 |
$1,208.40 |
$1,208.40 |
$1,669.00
|
|
Abdominal CT scan (without contrast)
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$1,358.76
|
|
Abdominal pad
|
$296.95 |
$296.95 |
$296.95 |
$151.32
|
|
Abdominoplasty 15830
|
$38,233.60 |
$38,233.60 |
$38,233.60 |
$6,442.80
|
|
Abduct control hip semi-flex
|
$756.91 |
$756.91 |
$756.91 |
$499.86
|
|
Abduction bar jointed adjust
|
$901.99 |
$901.99 |
$901.99 |
$595.67
|
|
Abduction rotation bar shoe
|
$318.97 |
$318.97 |
$318.97 |
$150.99
|
|
Abduct rotation bar without shoe
|
$291.67 |
$291.67 |
$291.67 |
$192.62
|
|
Abl1 gene
|
$1,071.60 |
$1,071.60 |
$1,071.60 |
$668.85
|
|
Ablate inf turbinate submuc 30802
|
$17,406.81 |
$17,406.81 |
$17,406.81 |
$1,752.89
|
|
Ablation cryo pq liver tumor(s)
|
$9,687.60 |
$9,687.60 |
$9,687.60 |
$8,581.80
|
|
Ablation cryo thigh/knee
|
$14,859.15 |
$14,859.15 |
$14,859.15 |
$531.95
|
|
Ablation of upper extremity nerves rf
|
$868.80 |
$868.80 |
$868.80 |
$832.50
|
|
Acetaminophen level
|
$130.80 |
$130.80 |
$130.80 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$160.68 |
$160.68 |
$160.68 |
$113.40
|
|
Acetone qualitative
|
$25.80 |
$25.80 |
$25.80 |
$43.80
|
|
Acetylcholine receptor modulating antibody
|
$61.80 |
$61.80 |
$61.80 |
$61.80
|
|
Acetylcholinesterase assay
|
$91.80 |
$91.80 |
$91.80 |
$112.00
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$12.72 |
$12.72 |
$12.72 |
$244.95
|
|
Acetylcysteine non-comp unit
|
$84.84 |
$84.84 |
$84.84 |
$31.21
|
|
Acup 1/> w/estim 1st 15 min
|
$89.40 |
$89.40 |
$89.40 |
$56.16
|
|
Acute hepatitis panel
|
$357.60 |
$357.60 |
$357.60 |
$281.09
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$21.96 |
$21.96 |
$21.96 |
$64.45
|
|
#acylcarnitineprfl
|
$165.60 |
$165.60 |
$165.60 |
$121.55
|
|
Adapter b 8 channel 10cm
|
$15,194.36 |
$15,194.36 |
$15,194.36 |
$6,142.50
|
|
Add le poly knee custom kafo
|
$683.95 |
$683.95 |
$683.95 |
$451.68
|
|
Adenosine 3 mg/250 ml bag for osm
|
$15.30 |
$15.30 |
$15.30 |
$271.98
|
|
Adenovirus ag ia
|
$54.60 |
$54.60 |
$54.60 |
$42.00
|
|
Adenovirus antibody,serum - quest
|
$117.60 |
$117.60 |
$117.60 |
$60.00
|
|
Adh-sendout
|
$253.20 |
$253.20 |
$253.20 |
$109.28
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$23,281.77 |
$23,281.77 |
$23,281.77 |
$2,995.08
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$192.18 |
$192.18 |
$192.18 |
$171.07
|
|
Administration chemotherapy IV infusion each additional hour
|
$157.80 |
$157.80 |
$157.80 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$213.00 |
$213.00 |
$213.00 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$1,235.40 |
$1,235.40 |
$1,235.40 |
$646.80
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$1,012.20 |
$1,012.20 |
$1,012.20 |
$439.55
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$961.80 |
$961.80 |
$961.80 |
$220.00
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$961.80 |
$961.80 |
$961.80 |
$264.70
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$31,980.84 |
$31,980.84 |
$31,980.84 |
$11,350.31
|
|
Adrenalin epinephrine inject
|
$46,614.50 |
$46,614.50 |
$46,614.50 |
$231.47
|
|
Aep hearing status deter i&r
|
$7,237.02 |
$7,237.02 |
$7,237.02 |
$303.05
|
|
Aep thrshld est mlt freq i&r
|
$2,984.40 |
$2,984.40 |
$2,984.40 |
$573.65
|
|
_afb id by dna probe rflx ast
|
$97.20 |
$97.20 |
$97.20 |
$93.52
|
|
#afb mycobacteria suscep. #1
|
$82.20 |
$82.20 |
$82.20 |
$38.58
|
|
_afb org id by sequencing rflx ast-sendout
|
$260.40 |
$260.40 |
$260.40 |
$289.60
|
|
Afo molded ankle gauntlet
|
$1,617.17 |
$1,617.17 |
$1,617.17 |
$765.51
|
|
Afo molded plas rig ant tib
|
$2,437.93 |
$2,437.93 |
$2,437.93 |
$2,011.42
|
|
Afo molded to patient plasti
|
$1,544.09 |
$1,544.09 |
$1,544.09 |
$697.20
|
|
Afo rig ant tib tcf/= custom
|
$2,111.34 |
$2,111.34 |
$2,111.34 |
$1,535.95
|
|
Afo sing bar clasp attach sh
|
$1,004.78 |
$1,004.78 |
$1,004.78 |
$663.56
|
|
Afo sing solid stirrup calf
|
$1,446.62 |
$1,446.62 |
$1,446.62 |
$955.35
|
|
Afo sing upright with adjust s
|
$1,471.85 |
$1,471.85 |
$1,471.85 |
$696.71
|
|
Afo spiral molded to pt plas
|
$1,819.66 |
$1,819.66 |
$1,819.66 |
$1,450.86
|
|
Afo sprng wir drsflx calf bd
|
$1,022.19 |
$1,022.19 |
$1,022.19 |
$483.88
|
|
Afo supramalleolar custom
|
$1,331.42 |
$1,331.42 |
$1,331.42 |
$1,162.69
|
|
Afo tib fx cast plaster mold
|
$1,864.98 |
$1,864.98 |
$1,864.98 |
$1,864.98
|
|
Afo tibial fracture rigid
|
$1,823.68 |
$1,823.68 |
$1,823.68 |
$1,464.20
|
|
Afo tibial fracture soft
|
$1,807.55 |
$1,807.55 |
$1,807.55 |
$1,060.02
|
|
Afo, walk boot type, cus fab
|
$3,754.63 |
$3,754.63 |
$3,754.63 |
$2,903.60
|
|
Afo w/ankle joint, prefab
|
$1,511.55 |
$1,511.55 |
$1,511.55 |
$567.00
|
|
Ak/knee disartic pelvic band
|
$280.98 |
$280.98 |
$280.98 |
$185.56
|
|
Ak/knee disartic silesian ba
|
$349.45 |
$349.45 |
$349.45 |
$156.80
|
|
Ak sleeve susp neoprene/equa
|
$633.05 |
$633.05 |
$633.05 |
$275.52
|
|
Albumin body fluid quantitative each specimen
|
$13.80 |
$13.80 |
$13.80 |
$47.50
|
|
Albumin (human), 25%, 50ml
|
$4,583.75 |
$4,583.75 |
$4,583.75 |
$219.08
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$40.80 |
$40.80 |
$40.80 |
$56.07
|
|
Albumin serum plasma or whole blood
|
$95.40 |
$95.40 |
$95.40 |
$40.00
|
|
Albuterol ipratrop non-comp
|
$3.00 |
$3.00 |
$3.00 |
$5.28
|
|
Albuterol non-comp unit
|
$4.44 |
$4.44 |
$4.44 |
$5.13
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$139.20 |
$139.20 |
$139.20 |
$94.90
|
|
Alkaline phosphatase
|
$43.20 |
$43.20 |
$43.20 |
$46.65
|
|
Allergen alpha lactalbumin ige
|
$67.20 |
$67.20 |
$67.20 |
$46.80
|
|
Allergen egg white ige
|
$52.80 |
$52.80 |
$52.80 |
$33.66
|
|
Allergen specific ige qual multi scrn ea
|
$32.40 |
$32.40 |
$32.40 |
$24.00
|
|
Allograft 160mg placental salera mini membrane
|
$10,010.89 |
$10,010.89 |
$10,010.89 |
$6,611.20
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$19,741.24 |
$19,741.24 |
$19,741.24 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$24,771.64 |
$24,771.64 |
$24,771.64 |
$2,677.80
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$18,991.01 |
$18,991.01 |
$18,991.01 |
$11,121.17
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$15,405.96 |
$15,405.96 |
$15,405.96 |
$5,913.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$69,935.50 |
$69,935.50 |
$69,935.50 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$46,951.01 |
$46,951.01 |
$46,951.01 |
$715.20
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$39,732.83 |
$39,732.83 |
$39,732.83 |
$4,677.40
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$37,515.51 |
$37,515.51 |
$37,515.51 |
$3,604.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$12,298.54 |
$12,298.54 |
$12,298.54 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$14,046.96 |
$14,046.96 |
$14,046.96 |
$1,495.63
|
